S8 L2 Lower GI Malignancy Flashcards

1
Q

Lower GI Malignancy
- Three key symptoms

A
  • Obstruction
  • Per Rectum (PR) bleeding
  • Change in bowel habit

Often need to look at these symptoms together

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2
Q

1st Main Symptom: Obstruction

  • What is this?
  • General symptoms
  • Large bowel (lower in GI tract) vs small bowel (higher in GI tract) symptoms, and explain the differences in symptoms
A

Small bowel - Nausea/vomiting
If malignancy is higher up, pressure will build up backwards.
More likely to present with: Vomiting

Large bowel - Constipation (absolute)
• Less likely to present with vomiting as need significant build up to cause this
• Constipation: ‘Absolute constipation’ (not passing any feacal matter or wind) must ask a patient if they are passing wind, as at risk of bowel perforation (could lead to peritonitis and then sepsis

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3
Q

Differentials for Obstruction

A
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4
Q

Red Flags - Obstruction

A
  1. Unintential weight loss
  2. Unexplained abdominal pain (i.e. not being able to find a reason for the pain)
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5
Q

2nd Main Symptom: PR Bleeding

  • Differntial Diagnosis
  • Nature of bleeding
A
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6
Q

PR Bleeding
- Red flags

A
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7
Q

3rd Main Symptom: Change in bowel habit

  • Type of changes that can occur…
  • Differentials for Change in Bowel habit
  • Red flags
A

Many benign causes of change in bowel habit!
• Age dependent
• Iron deficiency anaemia
• Unexplained weight loss
• PR blood loss

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8
Q

Large Bowel Cancer

  • Main type of large bowel cancer
  • Prevalence
  • Risk factors for it
  • Screening - how is this done? which group of people? who can have more reguar screens?
A
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9
Q

Transistion from Polyps to Adenocarcinoma…

A
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10
Q

Large Bowel cancer:
Right sided colon cancer vs Left sided colon cancer
- Signs and symptoms
- Differences in signs and symptoms
- Prognosis differences…

A
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11
Q

What may a left sided colon cancer look like with barium enema?

A
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12
Q

Small Bowel Cancer

  • Prevalance?
  • Different types…
  • Risk factors…
  • Symptoms…
A
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13
Q

General Management:
- Diagnosis (3 main types)

A
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14
Q

TNM staging

A
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15
Q

Duke’s Staging

A
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16
Q

Treatment

A
17
Q

Quandrants of the abdomen and which pathologies causes pain in which areas…

A
18
Q

GW:

  1. Name of the pain associated with gallstones
  2. Which cells produce CCK?
  3. 2 Potential complications of stone in proximal CBD?
  4. 2 Potential complications of stones in distal CBD
  5. Order of liver issues that occur due to chronic alcohol intake
  6. Which part of the stomach is the most common loication of gastric ulcers?
A
  1. Bilary colic
  2. I cells
  3. Gall bladder perforation, Post-hepatic jaundice
  4. Acute pancreatitis, Post-herpatic jaundice
  5. Fatty liver (leads to enlarged liver)
    Liver cirrhosis (leads to small liver)
  6. Lesser curve of the stomach